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15 February 2016, Volume 43 Issue 1
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The Role of Autophagy in the Development of Human Placenta and Placenta-Related Diseases CHANG Ying;CHEN Xu 2016, 43 (1):  5-7.  Abstract ( 1012 )   PDF (342KB) ( 5555 )   Autophagy plays a key role in the development of human placenta. But the biological significance of autophagy is still not clear. One possible role of autophagy is to protect trophoblasts from apoptosis induced by hypoxia or nutritional deprivation. The human placenta is hemochorial and maternal blood contact directly with chorion. Therefore, the villous trophoblasts are easily exposed to stress status caused by variable maternal blood flow. In pregnancy complications, such as preeclampsia and fetal growth retardation, the pathway of autophagy is activated to maintain cellular homeostasis allowing trophoblast cells to survive under shortage of oxygen and glucose. Autophagy is involved in development of the human placenta and placenta-related diseases, and changes in oxygen and glucose levels participate in regulation of autophagic changes in cytotrophoblast cells. Related Articles | Metrics

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Research Progress of Matrix Metalloproteinases in Preterm Premature Rupture of Membranes through Degrading Extracellular Matrix LI Wen;CHANG Ying;LI Xing;XU Ya-ling;CHEN Xu 2016, 43 (1):  8-10.  Abstract ( 1030 )   PDF (372KB) ( 5555 )   Preterm birth is the first critical factor of life, threatening diseases for the perinatal. According to the statistics, the preterm birth rate in China reached 8.1% in 2012. And the frequency of preterm premature rupture of membranes（PPROM） is about 25%-30%, and intrauterine infection is the principal element. The recent research shows that a molecular mechanism of PPROM is advanced degradation of extracellular matrix, which due to the activation of matrix metalloproteinases（MMPs） in fetal membrane. The high expression of cytokines, such as IL-1, IL-6 and TNF-α, maybe the reason of MMPs′ activation. The process of activation and secretion of MMPs in term labor and preterm birth still need to be explored, which may be considered as a marker of pregnancy outcome. MMPs can provide a breakpoint of prevention and therapy for PPROM. Related Articles | Metrics

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Progress of Pre-eclampsia Prediction Index in Clinical Application XU Ya-ling;CHANG Ying;CHEN Xu 2016, 43 (1):  11-14.  Abstract ( 1093 )   PDF (489KB) ( 5732 )   Pre-eclampsia is closely associated with increased maternal and perinatal mortality and morbidity. Early recognition of women at risk of pre-eclampsia can effectively strengthen the management of the pregnancy. The tests used to predict pre-eclampsia include clinical history, examination findings, laboratory and haemodynamic tests. In general, tests in early pregnancy for predicting later development of pre-eclampsia have better specificity than sensitivity, as body mass index greater than 34 kg/m2, alpha-fetoprotein, fibronectin and uterine artery doppler (bilateral notching) all have specificities above 90%. Only uterine artery doppler resistance index and combinations of indices have a sensitivity of over 60%. Test such as kallikreinuria not used in clinical practice, has shown high sensitivity above 80%, without compromising specificity, and require further investigation. At present, the clinical practice of pre-eclampsia prediction is the joint application of several parameters, not a check project with sufficient accuracy can be used independently. Related Articles | Metrics

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The Application of Cervical Cerclage in Prevention and Treatment of Abortion and Premature Birth ZHAO Xiao-min;CHEN Xu 2016, 43 (1):  15-17.  Abstract ( 1018 )   PDF (446KB) ( 5547 )   Premature delivery is the main cause of neonatal morbidity and mortality，and cervical incompetence is one of the major reasons that caused the late miscarriage and premature birth. Cervical incompetence is also called cervical insufficiency，it means that after pregnancy, before reaching full-term pregnancy, cervical performance flattening, thinning, cervical tube expansion or become wider, eventually led to the medium-term pregnancy abortion or premature birth. In Europe and other developing countries, reported preterm birth rates are around 5%-9% and this appears to have increased in some countries. Few interventions have improved outcome, and management remains an important challenge in modern obstetrics. Cervical cerclage is a common prophylactic intervention performed by obstetricians in the management of women with second-trimester losses or preterm deliveries, despite the lack of a well-defined population for whom there is clear evidence of benefit. The efficacy of cerclage is uncertain. In this paper, we will evaluation the cervical function and cervical cerclage indications in the second trimester of pregnancy. Related Articles | Metrics

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Clinical Research Progress in the Treatment of Twin-Twin Transfusion Syndrome by the Selective Laser Coagulation of Placental Vessels JIAO Zhi-hui;KONG Xiang-dong 2016, 43 (1):  18-20.  Abstract ( 1039 )   PDF (512KB) ( 5565 )   Twin-twin transfusion syndrome（TTTS） is a serious complication of a monochoric diamniotic pregnancy that may occur, and it has high fatality. Treatments of TTTS include expectation treatment, reducing amniotic cavity puncture of the amniotic fluid and selective laser coagulation of placental vessels（SLCPV）, the present study showed that SLCPV has obvious advantage in improving the survival rate，reducing the long term complications and thus become the first choice of treatment for TTTS. But due to the risk of fetal abortion，premature delivery and premature rupture of fetal membranes , thus how to make early diagnosis, early treatment so as to improve the survival rate and reduce long-term complications has increasingly cause the attention of experts at home and abroad. Related Articles | Metrics

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The Role of Matrix Metalloproteinase-9 in Normal and Pathologic Pregnancies ZHANG Jing-jing;HOU Hai-yan;CHEN Ya-qiong;YU Fang 2016, 43 (1):  21-24.  Abstract ( 1050 )   PDF (516KB) ( 5632 )   Matrix metalloproteinases (MMPs) are zinc proteinases that degrade compounds of the extracellular matrix (ECM), which are inhibited by their natural inhibitors, tissue inhibitors of matrix metalloproteinases (TIMPs). MMPs involve in many processes of tissue remolding through degrade ECM. A successful pregnancy depends on trophoblastic invasion of endometrial and implant embryo into uterus, through invasive vascular endothelial to make the vascular remodeling and meet the placental blood supply. MMP-9 plays an important role in trophoblast invasion, placental vascular remodeling and delivery through playing protease function and degrading ECM. The imbalance between MMP-9 and its inhibitor TIMP-1 relates to many pathological pregnancy processes, such as spontaneous abortion, preterm labour, hypertensive disorder complicating pregnancy and gestational diabetes mellitus. This article summarizes the role of MMP-9 in normal pregnancy and pathologic pregnancy. The current knowledge in the field of identified ECM proteases will be contributive to the innovative therapeutic intervention in pathological pregnancy processes. Related Articles | Metrics

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The Research Status of Vaspin and Gestational Diabetes Mellitus TANG Yu-ping;YING Hao 2016, 43 (1):  25-28.  Abstract ( 952 )   PDF (564KB) ( 5548 )   Gestational diabetes mellitus（GDM） is defined as an endocrine metabolic disease with glycometabolism disorder in varied degrees which firstly occur or is identified during pregnancy. It is a serious but common threat to the health of mother and fetal. Recent research shows that increased insulin resistance（IR） caused by abnormal adipose cytokines secretion might be one of the pathogenesis of GDM. Vaspin（visceral adipose tissue-derived serine protease inhibitor）, as a newly discovered adipose cytokines with insulin-sensitizing and improving insulin resistance effects, probably plays an important role in the development of type 2 diabetes and GDM. Recently, there are some researches between vaspin and GDM, but the results are different. This review is aimed to summarize the change of vaspin during pregnancy and the relationship between vaspin and GDM. Related Articles | Metrics

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Effects of Fetal Growth Restriction on the Development of Kidney WANG Yan-ping;WANG Guan;CUI Hong-yan;ZHANG Zhi-kun 2016, 43 (1):  29-31.  Abstract ( 971 )   PDF (592KB) ( 5556 )   Objective：To investigate the effect of intrauterine environment of fetal growth restriction（FGR） on the development of fetal kidney. Methods：Renal specimens of 11 fetal growth restriction（FGR） cases and 12 non-FGR cases were collected from November 2009 to December 2011 in the department of obstetrics of Tianjin Central Hospital of Gynecology Obstetrics. The mass and volume were calculated first，and the apoptosis rate of cells was analyzed by TUNEL. In addition，the positive expression rate of Bcl-2 and Bax proteins in apoptotic cells were also detected. Results：Compared with the non-FGR group，the average volume，quality and number of renal units were significantly decreased in the FGR group （P＜0.01）, while the apoptosis rate of cells was significantly increased （P＜0.01）. The positive expression rate of pro-apoptotic protein Bax in the FGR group cells was significantly increased（P＜0.01），with the expression rate of anti-apoptotic gene Bcl-2 decreased（P＜0.01） after future detection. Conclusions：Our study indicates that increased apoptosis may effect human kidney development in FGR environment，which is helpful to provide new clues for further exploring the molecular mechanism of FGR and the pathogenesis of adult diseases. Related Articles | Metrics

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Physiological Changes in Hematological Parameters of Normal Pregnant Women before and after Cesarean Delivery LI Xing;CHANG Ying;CHEN Xu 2016, 43 (1):  32-34.  Abstract ( 1625 )   PDF (592KB) ( 5751 )   Objective：To establish the reference intervals for hematologic parameters in antepartum and 24 hours after postpartum in healthy pregnant women, and analyze physiological changes occurring in hematologic parameters. Methods: The samples comprised of healthy pregnant women who had cesarean section at term in Tianjin Central Hospital of Gynecology Obstetrics from Jun. 2015 to Oct. 2015. The blood test results before and after delivery were retrospectively analyzed. Results: The reference intervals obtained before delivery were: RBC, （3.27～4.49）×1012/L; Hb, 93.4～135.3 g/L; HCT, 0.286～0.399; WBC, （5.47～12.34）×109/L; PLT, （113.7～307.0）×109/L. After delivery, RBC count and PLT dropped significantly(P=0.002, P=0.000, respectively), and WBC count increased significantly(P=0.000), Hb and HCT levels remained unchanged, and the value of MCV,MCH, MCHC slightly increased, the percentage of neutrophils and intermediate cells increased significantly(P=0.000), while the percentage of lymphocytes dropped significantly(P=0.000). Conclusions: The reference intervals for Hb concentration and PLT in healthy prgnant women showed some differences with non-pregnant women. Compared with antepartum, the WBC count increased after delivery, while the RBC count and PLT count dropped. The differences observed underscore the need to establish reference values for Chinese women before and after delivery. Related Articles | Metrics

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Analysis of Serological Screening Results of 9 508 Pregnant Women in the Second Trimester of Pregnancy YANG Xiao;GUO Jia;PENG Wei;ZHU Li-na;WANG Yan 2016, 43 (1):  35-38.  Abstract ( 976 )   PDF (666KB) ( 5654 )   Objective：Retrospectively analyzed the serological screening results of pregnant women in their second trimester, to explore the significance of serological screening. Methods：The concentration of alpha-fetoprotein（AFP），beta subunit of human chorionic gonadotropin（β-hCG） and unconjugated estriol （uE3） was detected in serum of 9 508 pregnant women （15-20+6 gestational weeks） in obstetrics and gynecology department of Beijing Military General Hospital from September 2010 to March 2014. Risks were assessed by combination with maternal age，gestational age and weight of pregnant women. Results：Among all the 9 508 screening women, 743 cases were detected at high risk，and the positive rate was 7.81%. In which，the Down′s syndrome（DS） high-risk rate was 5.92%（563/9 508），the 18-trisome high-risk rate was 0.20%（19/9 508），the neural tube defects（NTD） high- risk rate was 1.69%（161/9 508）. Karyotype analysis of amniotic fluid cells confirmed DS 5 cases，18-trisomy 1 case，other chromosomal abnormalities 12 cases . The study showed that the high-risk rate of DS and NTD between 4 group（aged 20-, 25-,30- and ≥35） were significantly different（P＜0.01）. The DS high-risk rate of pregnant women aged over 35 was significantly higher than that of pregnant women aged under 35（P＜0.01）. One false positive in DS was found in low risk pregnant women during follow-up. Conclusions：Prenatal serological screening has certain guiding significance in reducing birth defects and improving population qualities. Related Articles | Metrics

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Study on Oxidative Stress Injury Levels in Serum and Placenta of Pre-eclampsia in Pregnant Women Complicated with Organ Involvement XU Xia;ZHANG Yan-zhen;WANG Hui-lan;JIANG Hui-fang;ZHANG Min-fang 2016, 43 (1):  39-41.  Abstract ( 967 )   PDF (659KB) ( 5552 )   Objective：To investigate oxidative stress injury levels in serum and placenta of pre-eclampsia（PE） in pregnant women complicated with organ involvement. Methods： 30 PE patients complicated with organ involvement who were admitted to Fujian Medical University Union Hospital for delivery from December 2012 to December 2014 were chosen as study group, 30 patients without organ involvement were chosen as control group one, another 30 normal pregnant women at the same time were chose as control group two. Ultraviolet colorimetry was used to detect glutathione peroxidase（GPX） and catalase（CAT） activity in maternal serum and placenta, as well as the malondialdehyde（MDA） level. WST was used to detect superoxide dismutase（SOD） activity in serum and placenta. Results：①Mean maternal serum and placenta GPX，CAT and SOD activity were significantly decreased in the study group and control group one as compared to control group two, study group were also lower than the control group one, both of the difference had statistical significance（P＜0.05）. ②Mean maternal serum and placenta MDA were significantly elevated in the study group and control group one as compared to control group two, and the study group were also higher than the control group one, both of the difference had statistical significance（P＜0.05）. ③Mean maternal serum and placenta MDA concentration were negatively correlated with the levels of GPX，CAT and SOD in study and control group one（P＜0.05）. No obvious correlation was found in the control group two. Conclusions：Serum and placenta enhanced oxidative stress damage may be an important factor in the onset of PE, and can lead to PE women concurrent organ involvement. Antioxidant enzyme activity in serum and placental tissue levels drop may be the cause of the elevated levels of serum and placenta oxidative stress injury. Related Articles | Metrics

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Study on the Placental Expression of BSEP in Intrahepatic Cholestasis of Pregnancy GU Li-ping;LIU Xiao-hui;SONG Ye;HOU Shun-yu;DAI Jian-rong 2016, 43 (1):  42-44.  Abstract ( 941 )   PDF (687KB) ( 5604 )   Objective：To explore the expression of bile salt export pump（BSEP） in placenta tissue and its relationship with intrahepatic cholestasis of pregnancy（ICP）. Methods：The expression of BSEP in the placenta was detected by immunohistochemistry and western blotting respectively in 30 women with ICP（ICP group） and 30 normal gravidas（control group） from February 2012 to August 2013 in Department of Obstetrics of Suzhou Municipal Hospital. Results：BSEP was located at the cytoplasm in the placental trophoblastic cells. The expression of BSEP in ICP group was significantly lower than control group [（0.197 7±0.111 8） vs. （0.616 0±0.384 9），P＜0.001]. Conclusions：Decreased expression of BSEP in placenta may be associated with ICP. Related Articles | Metrics

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The Protection Effect and Mechanism of Schisandrin B on Extravillous Trophoblast Cell Line Damage Caused by BaP WU Nian;CHEN Ya-qiong;CHEN Xiao;HOU Hai-yan;WANG Hua 2016, 43 (1):  45-48.  Abstract ( 928 )   PDF (753KB) ( 5593 )   Objective：To explore the protection mechanism of Schisandrin B on extravillous trophoblast cell line damage caused by BaP. Methods：After 0.5，1，2 μmol/L Sch B deal with human HTR8-SVneo cells 24 h，added 20 μmol/L Bap 24 h，using MTS measured cells growth. Used JC-1 fluorescent staining to measure the change of mitochondrial membrane potential in each group. Respectively used ELISA to measure the concentration of Bax and cyt-c protein in each group. Respectively used Western blotting to analyse the expression of caspase-9 in each group. Results：①MTS results showed that BaP alone cell OD was 1.187±0.015，0.5，1，2 μmol/L Sch B the role of OD was 1.483±0.022，1.489±0.048 and 1.531±0.240，compared with BaP alone group，the differences were statistically significant（P＜0.05）. ②JC-1 fluorescent staining results showed that BaP alone cell mitochondrial fluorescent intensity was lower and 0.5，1，2 μmol/L Sch B the role of mitochondrial fluorescent intensity was higer. Compared with BaP alone group，the differences were statistically significant（P＜0.05）. ③ ELISA results showed that BaP alone cell the concentration of Bax，cyt-c protein were higher and 0.5，1，2 μmol/L Sch B the role of the concentration of Bax，cyt-c protein were lower，respectively. Compared with BaP alone group，the differences were statistically significant（P＜0.05）. ④Western blotting results showed that BaP alone cell the concentration of caspase-9 protein was higer，and 0.5，1，2 μmol/L Sch B the role of the concentration of caspase-9 protein was lower，respectively. Compared with BaP alone group，the differences were statistically significant（P＜0.05）. Conclusions：Schisandrin B can prevent damage of extravillous trophoblast cell line caused by BaP，whose mechanism may be associated with resistance to mitochondrial pathway. Related Articles | Metrics

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Application of Metabonomics in the Diagnosis and Treatment of Gynecologic Malignant Tumor YAO Ting;HOU Hai-yan;CHEN Ya-qiong 2016, 43 (1):  55-57.  Abstract ( 1036 )   PDF (842KB) ( 5561 )   Metabonomics is a new scientific discipline developing in the 1990s, qualitative and quantitative analysis are carried out to analyze all the low molecular weight metabolites in an organism or cell, metabonome changes can reflect the patho-physiologic changes of an organism under a certain time and a certain condition. Ovarian cancer，cervical cancer and endometrial cancer are three major gynecologic malignant tumor，they have high mortality rate，high recurrence rate，low survival rate，long course and so on，their metabolites are different in the early stage and different clinical stages of disease, detected by the metabonomics method is conducive to deeply realize the occurrence and development of malignant tumor，early diagnosis of the disease, analyzing the metabolites produced during treatment is helpful for individual treatment of tumor，metabonomics can also be used in drug efficacy evaluation, which is benefit for discovering new antitumor drugs. Related Articles | Metrics

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Research Progress of Laparoscopic Learning Curve in Gynecological Malignant Tumor HE Hong-ying;YANG Zhi-jun;LU Ying-xin;LI Li 2016, 43 (1):  58-62.  Abstract ( 1299 )   PDF (787KB) ( 5591 )   Gynecologic malignant tumor has been the main killer threatening to women′s life. Surgery is a main treatment for most of the gynecology malignant tumor. With the development of minimally invasive surgical techniques，the laparoscopic surgery in gynecological malignant tumor has been admired and promoted. Learning curve, also called as experience curve, refers to get the rate of knowledge or skills in a certain period of time. It is widely used in the research on the rules of surgical skills acquisition. The main evaluation standard of learning curve includes operation time, intraoperative blood loss, conversion rate, the number of lymph node cleaning, transfer laparotomy and intraoperative and postoperative complications, postoperative hospital stay, and so on. Currently the laparoscopic surgery technology of gynecologic malignant tumor, such as endometrial cancer, cervical cancer, ovarian cancer, vaginal cancer, vulva cancer, has become increasingly mature, but the learning curve of various gynecological malignant tumor laparoscopic surgery reported is not the same. At present，there is not an international comprehensive description with the evaluation standard，the affecting factors and the existing defects of the learning curve in laparoscopic surgery. This article reviewed and revealed the progress of laparoscopic learning curve in gynecological malignant tumor. Related Articles | Metrics

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Progress of the Minimally Invasive Operation Technologies for Endometrial Cancer LIU Hong;WANG Rong-rong;DU Meng-meng;WANG Hai-lin 2016, 43 (1):  63-66.  Abstract ( 1394 )   PDF (754KB) ( 5516 )   The transformations of medical pattern bring the challenge for the minimally invasive surgical. With the innovation of the science and medical technology, minimally invasive technology developed quickly in recent 20 years. It has been applied to the management of gynecologic malignancies with promising result. Its advantage involving the relatively small incision, less intraoperative blood loss and operative complication, shorter hospital stay, faster recovery and so on. Not only that, compared with traditional laparotomy, it has no obvious difference with regard to the number of dissected lymph nodes, overall and disease-free survival rates. So it is safety and feasibility to treat endometrial cancer. At present, minimally invasive operation technologies for endometrial cancer, including traditional laparoscopic surgery, laparoscopic single-site surgery, robotic surgery and robot assisted laparoscopic single-site surgery. In this article the application of minimally invasive surgical in treating endometrial cancer is reviewed, involving the advantages, limitations and future direction of minimally invasive surgery. Hoping to provide some help for clinicians according to patients condition to choose operation. Related Articles | Metrics

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The New Progress of Lynch Syndrome Related Endometrial Cancer LIU Da-jiang;DU Wen-jing;YANG Yong-xiu 2016, 43 (1):  67-69.  Abstract ( 1011 )   PDF (716KB) ( 5551 )   Endometrial carcinoma is the most common parenteral tumor in female patients with Lynch syndrome. The disease is different from sporadic endometrial carcinoma, which is autosomal dominant genetic disease, and the pathogenesis and mechanism are the abnormalities of mismatch repair genes（MLH1，MSH2，MSH6 and PMS2）. Patients are much younger compared to sporadic endometrial carcinoma and pathological type is more diversity, including endometrial carcinoma, clear cell carcinoma, serous carcinoma and undifferentiated carcinoma and sarcoma, etc. Due to the higher risk of tumor recurrence and its great harmfulness of the disease，timely treatment of the Lynch syndrome related endometrial carcinoma is the key to inhibit the secondary tumor. This article is to summarize the new progress the etiology and pathogenesis of endometrial carcinoma，the clinical pathological characteristics and diagnosis，treatment and screening of Lynch syndrome related endometrial carcinoma. Related Articles | Metrics

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Research Progress of the Combination of Antiangiogenic Agents and Chemotherapy for Recurrent Ovarian Cancer ZHANG Jie;WANG Xiao-hui 2016, 43 (1):  70-74.  Abstract ( 956 )   PDF (905KB) ( 5681 )   Ovarian cancer is one of the common gynecologic malignant tumors. The development of it and the metastases of tumor cells need new blood vessels. Therefore, by inhibiting tumor angiogenesis is one of effective ways to treat ovarian cancer. The main antiangiogenic agents included vascular endothelial growth factor inhibitor （such as Bevacizumab）, tyrosine kinase inhibitors （such as Sorafenib, Pazopanib and Cediranib）, and angiogenin inhibitor （such as Trebananib）. The combination of antiangiogenic targeted agents with chemotherapy has been shown to benefit patients with platinum-sensitive or platinum-resistant recurrent ovarian cancer by lots of phase Ⅱ and Ⅲ clinical trials. Meanwhile, combination with chemotherapy provided a clinically meaningful prolongation in progression-free survival. This paper reviewed clinical research status and the latest development with the combination of different antiangiogenic targeted agents and chemotherapy in patients with recurrent ovarian cancer. Related Articles | Metrics

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The Possible Advantages and Disadvantages of Prophylactic Bilateral Salpingectomy ZHENG Ting-ting;LI Ai-jun;BAI Jing 2016, 43 (1):  75-79.  Abstract ( 963 )   PDF (916KB) ( 5521 )   The morbidity of ovarian serous cancer has been risen up in recent years. It develops rapidly to the terminal stages. Recent studies reveal that pelvic serous carcinoma or precancerosis may come from the fallopian tubal fimbria and the fallopian tube-peritoneal junction（TPJ） is possible related to the ovarian surface carcinoma. Prophylactic bilateral salpingectomy（PBS） in standard hysterectomy in premenopausal women with benign condition may be a strategy for preventing pelvic serous cancer and ovarian surface carcinoma． Besides，fallopian tube mesenchymal stem cells（FTMSC） have been found in fallopian tube，which can be a new source of multipotential stem cell.It is superior to other tissues in the reconstruction of genital system. To evaluate this procedure，we reviewed the theory of pelvic serous carcinoma associated with the fallopian tube, the effectiveness of PBS in reducing the risk of malignant or benign pelvic lesions, surgical or perioperative complications, the application of PBS in other fields as well as the effects of PBS on ovarian function． Related Articles | Metrics

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The Radiotherapy and Progress for Vulvar Cancer HUANG Zhi-jiong;GAO Kun 2016, 43 (1):  80-83.  Abstract ( 1375 )   PDF (776KB) ( 5601 )   The treatment of vulvar cancer is difficult. The radical surgery is a therapy that would result in a high disability and a poor quality of life for patients who have undergone this mutilated treatment. Radiotherapy plays an increasingly important role in the individualized and comprehensive treatment of vulvar cancer. Preoperative radiotherapy is expected to get a radical surgery without viscera resection for the advanced patients who can not be operated at first. Postoperative radiotherapy is mainly aimed to reduce the risk of recurrence after surgery for the patients who have high risk factors of recurrence. Radical radiotherapy can make the patient avoid the severe complications of surgery and ensure the quality of life after treatment. However , the long-term effect remains to be further research. As a new approach of radiotherapy, the intensity modulated radiation therapy (IMRT) combines with concurrent chemoradiation may be expected to make an effective treatment and a high quality of life for vulvar cancer. Related Articles | Metrics

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Serum sTWEAK，TNF-α and IL-10 Expression and Their Clinical Significance in Epithelial Ovarian Cancer Patients HUANG Yu-li;QIU Li-hua 2016, 43 (1):  84-86.  Abstract ( 895 )   PDF (836KB) ( 5545 )   Objective：To explore the expression level and clinical implications of serum sTWEAK，TNF-α and IL-10 in epithelial ovarian cancer（EOC） patients. Methods：Totally 43 patients with EOC（EOC group） and benign epithelial ovarian tumor （BOT group） were selected from Renji Hospital，School of Medicine，Shanghai Jiao Tong University. These patients were admitted to the hospital during the period from January 2010 to February 2014. The levels of serum sTWEAK，TNF-α and IL-10 were detected by ELISA. Results：①Compared to the BOT group，the expression levels of sTWEAK （P＜0.05） and TNF-α（P＜0.01） were significantly increased in the EOC group，the elevation of IL-10 level was not significant （P＞0.05）. ②The expression levels of sTWEAK，TNF-α and IL-10 in peripheral serum in EOC group were not significantly different with different clinical stages，pathological types， histological grade and ascites presence of tumor cells（P＞0.05）. ③In both two groups，the expression level of sTWEAK was positively correlated with serum TNF-α（rs=0.505，P=0.001）and was no correlation with serum IL-10（rs=0.154，P=0.325）. Conclusions：Serum sTWEAK and TNF-α expression levels were closely correlated with the pathogenesis of EOC. In patients with high sTWEAK expression，the expression of TNF-α was dominant. Related Articles | Metrics

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Factors Associated with Lymph-Vascular Space Invasion in Cervical Cancer LI Yu;WANG Xi-peng 2016, 43 (1):  87-91.  Abstract ( 1072 )   PDF (875KB) ( 5581 )   Objective：To analyze the relationship between the lymph-vascular space invasion（LVSI） in cervical cancer and other histo-pathologic parameters, in order to provide some guidance for choosing treatment. Methods：Clinical and pathological data of 462 cervical cancer patients were analyzed retrospectively from April 2003 to May 2013 in Shanghai First Maternity and Infant Hospital of which LVSI positive（40%） and 277 cases negative（60%）. An analysis was done in terms of the relationship between LVSI and stage and grade of the disease, as well as lymph-node metastasis and other histo-pathologic parameters. Results：In single variable analysis, the presence of LVSI appeared to have obvious relationship with FIGO staging, tumor size, depth of tumor invasion, lymph-nodes metastasis and whether neoadjuvant therapy, but there was no statistic significance with whatever neoadjuvant therapy use. In multivariable analysis, LVSI appeared to have significant association with other histo-pathologic parameters such as histopathological types, stromal invasive depth, tumor size, parametrial infiltration and lymph-nodes metastasis. And the incidence of LVSI was elevated with the increasing number of parameters. Conclusions：LVSI closely related with other pathological risk factors. LVSI can hint the potent danger of lymph-nodes metastasis, and can provide guidance for clinically treatment. Related Articles | Metrics

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Biological Characteristics and Their Latest Research Progress of Human Umbilical Cord Wharton′s Jelly-Derived Mesenchymal Stem Cells HE Bei;YANG Xiao-qing;ZHANG Yu-quan 2016, 43 (1):  94-98.  Abstract ( 1072 )   PDF (857KB) ( 5571 )   Human umbilical cord Wharton′s jelly-derived mesenchymal stem cell （hWJ-MSC） is a kind of adult stem cell which has self-renewal ability, multiline age differentiation potential. As isolated from discarded tissue (umbilical cord) after birth, they are considered wide resource, easy to be acquired and not restricted by ethics. Compared to other source of adult stem cells such as bone marrow mesenchymal stem cells, hWJ-MSC has lower immunogenicity, higher proliferation, more primitive stem cell performance, which make hWJ-MSC become a new cell resource. hWJ-MSC has great therapeutic potential in cell transplantation, gene therapy for various diseases. In this review, we will discuss the biological characteristics, proliferation and differentiation potential, and immunological characteristics of hWJ-MSC, and mainly focus on the latest progress of their application on various diseases. Related Articles | Metrics

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The Current Status of Cesarean Scar Pregnancy LIU Yu-jie;ZONG Li-li 2016, 43 (1):  99-102.  Abstract ( 927 )   PDF (853KB) ( 5511 )   In recent years, China has loosened its decades-long one-child population policy, allowing couples to have two children. Consequently, an increasing number of women who had received cesarean section come across cesarean scar pregnancy (CSP) during their following pregnancies. More concerns should be strengthened by our obstetricians and gynecologists considering the risks of its severe complications, such as hemorrhea and uterine rupture. Two main symptoms of CSP are vaginal bleeding and abdominal pain after amenorrhoea, and it could be diagnosed and further classified by the transvaginal ultrasonography, MRI and hysteroscopy. In recent years, researchers have focused on the pathogenesis, risk factors and new treatment methods of the CSP, which would be introduced in this article. Moreover, the recurrent CSP and its risk factors and treatments would also been identified here. Related Articles | Metrics

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Relationship between Homocysteine, Lipid, CRP, NLR Levels and Osteopenia in Postmenopausal Women LIU Wen-hua;TANG Shan-shan;HUANG Zhe-ren;WEI Shuang-shuang;ZHANG Zhi-fen;CHEN Lin-jie 2016, 43 (1):  103-106.  Abstract ( 941 )   PDF (995KB) ( 5564 )   Objective：To explore the relationship between homocysteine, lipid levels, CRP, NLR and Osteopenia in postmenopausal women. Methods：We collected 269 postmenopausal women from Gynecological Clinic of Hangzhou Hospital of Nanjing Medical University, who aged 45 to 60 years old, never used menopause hormone therapy. According to the bone mineral density(BMD) determination results subjects were divided into normal group (n=128) and osteopenia group (n=141). BMD was measured by dual-energy X-ray absorptiometry (DXA). Homocysteine were measured by enzyme chemiluminescence immunoassay. CRP and lipid indexes using chemiluminescence immunoassay. Results：There were significant differences between the two groups in menopause age, duration of menopause and serum levels of LDL, CRP, HCY and NLR(P＜0.05). Menopausal age, duration of menopause, LDL, CRP, HCY and NLR are risk factors in postmenopausal women with osteopenia. The odds ratios and 95% confidence intervals of those variables were found to have significant difference between the two groups(P＜0.01), and were as follows 0.755（0.623～0.914），1.408（1.043~1.901），1.038（1.018~1.058），1.398（1.115~1.753），3.534（2.355~5.303） and 3.959（2.148~7.299）. Conclusions：Menopausal age, duration of menopause, serum levels of LDL, CRP, HCY and NLR can be used as the evaluation index of bone loss in postmenopausal women. Related Articles | Metrics

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The Effects of 17β-Oestradiol on the Nervous System of Ovariectomized Rats TANG Shan-shan;ZHANG Zhi-fen;LIU Wen-hua;HUANG Zhe-ren;WEI Shuang-shuang 2016, 43 (1):  107-110.  Abstract ( 937 )   PDF (885KB) ( 5503 )   Objective：Investigate the effects of exogenous estrogen on the expression of nuclear transcription factor（Nrf2），heme oxygenase-1（HO-1），silent information regulator 1（SIRT1），and the changes of the neuronal morphology and volume in the hippocampus and cortex of those ovariectomized rats，so as to explore the beneficial effects of estrogen on the nervous system. Methods：Forty female Sprague-Dawley（SD） rats aged three months were randomly divided as follows：①control group（CON），②sham operation group（SHAM），③ovariectomized group（OVX），④treated group（OVX+E2）. There were 10 rats in each group. The OVX+E2 group were treated with 17β-oestradiol intragastric administration，the other groups were given saline daily. After 16 weeks，Nrf2/HO-1 and SIRT1 levels in the hippocampus and cortex were detected by immunohistochemistry. Then observe the morphology of neurons from cerebral cortex and hippocampus CA1 region. Results：①Compared with the SHAM group，the Nrf2/HO-1 level in hippocampus and cortex of the OVX group was significantly increased，while SIRT1 level was significantly decreased ；Compared with the OVX group，Nrf2 and SIRT1 level of the OVX+E2 group was significantly increased，while HO-1 level was significantly decreased. ②There were not significant differences in the number and arrangement of neurons between OVX+E2 group and SHAM group，and the number of tigroid body in hippocampus and cortex of the OVX group was reduced，the morphological alteration of the neuron were disordered. Conclusions：Exogenous oestradiol increased the Nrf2/SIRT1 level but reduced HO-1 level in the hippocampus and cortex of the ovariectomized rats，maintaining neuronal number and structure，thereby protecting the nervous system. Related Articles | Metrics

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The Clinical Pathology Analysis of 778 Patients with Postmenopausal Bleeding LIU Qing-qing;YANG Qing 2016, 43 (1):  111-115.  Abstract ( 910 )   PDF (888KB) ( 5611 )   Objective：To explore the clinical features and pathologic type of postmenopausal vaginal bleeding. Methods: A retrospective analysis was performed from January 1, 2008 to December 31, 2013 at China Medical University Sheng Jing Hospital gynecology wards after a total of 778 cases of postmenopausal bleeding women, each patient underwents pelvic ultrasound, hysteroscopy and surgery and obtain pathology and definitive diagnosis. Results: From 778 cases of patients, endometrial polyps accounts for the highest proportion of 49.23% (383 cases), the second is endometrial cancer 16.71% (130 cases), the third is the submucous myoma 11.44% (89 cases). The most number of cases within 5 years of menopause are postmenopausal vaginal bleeding(311 cases), most of which is endometrial polyps(175 cases), and for menopause more than 21 years, there are the lowest incidence cases (78cases), most of which is endometrial cancer (44 cases). The vaginal bleeding cases are the least (7 cases) for those who are younger than 49, and the most cases (228 cases) for those between 55 to 59 years old, most of which are endometrial polyps. There are 71 patients older than 75 years of age, most of which are endometrial carcinoma(38 cases). In the endometrial thickness, body mass index(BMI), and whether repeated bleeding, endometrial benign and malignant disease has the obvious statistical significance (P＜0.01). Compared with the patients with endometrial benign lesions, endometrial malignant lesions patients own thicker endometrial, greater body mass index (BMI), and are more likely to be repeated bleeding. Conclusions: The main reason caused postmenopausal vaginal bleeding is uterine benign lesions. As the menopause time increasing, endometrial polyps, endometrial hyperplasia and the incidence of submucosal myoma is downward trend on the whole, endometritis, and the incidence of endometrial cancer is on the rise as a whole. With the increase of vaginal bleeding after menopause age, endometrial polyps, endometrial hyperplasia and the incidence of submucosal myoma is downward trend on the whole, endometritis, and the incidence of endometrial cancer is on the rise as a whole. Related Articles | Metrics

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The Effect of the Prolift Procedure on the Pelvic Floor Muscle Strength in POP Patients GONG Yao;WANG Jian-jun;LI Huai-fang;TONG Xiao-wen 2016, 43 (1):  116-118.  Abstract ( 939 )   PDF (819KB) ( 5567 )   Objective：To evaluate the change of the pelvic floor muscle （PFM） strength in patients with pelvic organ prolapse (POP) before and after the Prolift procedure. Methods: The study recruited 37 POP patients with stage Ⅱ-Ⅳ under POP-quantification from March 2011 to April 2013 in Tongji Hospital Affiliated Tongji University. The PFM strength was measured by digital examination and surface electromyography (SEMG) to evaluate the changes of PFM strength in patients before and after surgery, and compare with patients with normal pelvic floor function. Results: Prolift surgery can effectively improve the patient′s state of pelvic organ prolapse. There are a total of 36 postoperative POP patients whose POP-Q index decreased, and reached anatomical reduction. After the 6 months′ follow-up, the Oxford degree of PFM, pelvic floor muscles maximum voltage and duration of the muscle contractions increased significantly in the Prolift group(P=0.000), but lower than patients with normal pelvic floor function (P=0.000）. Conclusions: The Prolift procedure could restore the pelvic anatomy and partly improve the PFM strength. Related Articles | Metrics